학술논문

A phase I trial adding poly(ADP-ribose) polymerase inhibitor veliparib to induction carboplatin-paclitaxel in patients with head and neck squamous cell carcinoma: Alliance A091101
Document Type
article
Source
Subject
Biomedical and Clinical Sciences
Clinical Sciences
Oncology and Carcinogenesis
Clinical Research
Dental/Oral and Craniofacial Disease
Clinical Trials and Supportive Activities
Rare Diseases
Cancer
6.2 Cellular and gene therapies
Evaluation of treatments and therapeutic interventions
6.1 Pharmaceuticals
Adult
Aged
Antineoplastic Combined Chemotherapy Protocols
Benzimidazoles
Carboplatin
Female
Humans
Male
Middle Aged
Paclitaxel
Poly(ADP-ribose) Polymerase Inhibitors
Squamous Cell Carcinoma of Head and Neck
Young Adult
Head and neck squamous cell carcinoma
Induction therapy
PARP inhibition
Veliparib
Dentistry
Public Health and Health Services
Oncology & Carcinogenesis
Oncology and carcinogenesis
Language
Abstract
ObjectivesWe report the results of this phase I study to evaluate the maximum tolerated dose (MTD) and safety of veliparib, a poly(ADP-ribose) polymerase (PARP) inhibitor, combined with carboplatin and paclitaxel induction chemotherapy (IC) for locoregionally advanced head and neck squamous cell carcinoma (HNSCC).Materials and methodsIn a 3 + 3 cohort design, patients with stage IVA-B human papillomavirus-negative HNSCC received 2 cycles of carboplatin (AUC 6, day 1), paclitaxel (100 mg/m2, days 1, 8, 15) and veliparib (days 1-7) every 21 days followed by standard curative-intent chemoradiotherapy. Primary endpoint: MTD and recommended phase II dose (RP2D) as determined by the first IC cycle.ResultsTwenty patients enrolled. Two withdrew before treatment; 18 patients were analyzed. Median age was 63 years. Primary disease sites included hypopharynx (n = 5), larynx (n = 5), oral cavity (n = 4), oropharynx (n = 3), and nasal cavity (n = 1). Through all of IC, the most common grade 3 + adverse events (AEs) were neutropenia (33%), thrombocytopenia (33%), anemia (11%), and white blood cell decrease (11%). One patient experienced a hematologic DLT at 350 mg BID. The RP2D for veliparib combined with carboplatin/paclitaxel is 350 mg BID. With 40.9 month median follow-up across dose levels for all patients, the 24-month overall and progression free survival was 77.8% (95% CI 60.8-99.6%) and 66.7% (95% CI 48.1-92.4%), respectively. Medians have not been reached.ConclusionAddition of veliparib to carboplatin and paclitaxel IC was well tolerated in patients with advanced HNSCC. Hematologic toxicities were the most common AEs.